YOUR GROUP S PRIVATE & PUBLIC REPORT ENCLOSED

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1 YOUR GROUP S PRIVATE & PUBLIC REPORT ENCLOSED Please read the enclosed documents for important information regarding your group s public report of quality data. Responses must be received by April 4th, 2014 to OPT OUT of public display of data.

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3 Name Address City, State Zip February 18, Major Funding Partners Boehringer Ingelheim General Electric Company UAW/Ford Motor Company 201 Leadership Level Committee Members Platinum Membership Anthem Blue Cross Blue Shield Humana, Inc. KentuckyOne Health Norton Healthcare Gold Membership Baptist Health Employer Solutions Louisville Gas & Electric KU KentuckyOne Health Partners Silver Membership American Commercial Lines Greater Louisville Medical Society Merck Monroe Associates Novo Nordisk Inc Passport Health Plan Pfizer, Inc. Republic Bank sanofi Walgreens Bronze Membership Bluegrass Family Health Crounse Corporation Kentucky Diabetes Network KY Coordinated Chronic Disease Prevention & Health Promotion Program KY Diabetes Prevention & Control Program KY Heart Disease & Stroke Prevention Program Lilly USA, LLC Steve Barger Consulting, LLC 201 KHC Committee Members Abbvie All Children s Pediatrics, PLLC Baptist Health Colon Cancer Prevention Project CoventryCares of Kentucky Friedell Committee for Health System Transformation Health Care Excel of Kentucky John Lewis, MD Kentucky Office of Health Policy Metropolitan Sewer District Office of KY Health Benefit Exchange Orr Corporation Signature Healthcare United Food Commercial Workers Local 227 & Employers Health Plan UofL School of Public Health & Information Sciences Dear Provider: For the first time in 2014, your group practice s consolidated measurement reports will be publicly displayed on a new website under development called HealthShare. Enclosed are two Consolidated Measurement Reports; one will be for your internal private review and another for showing what measures and scores will be publicly displayed in 2 nd quarter You have a 4 day review period to OPT OUT from public display of your data (see enclosed form). This public reporting effort was designed by the Kentuckiana Health Collaborative (KHC), a consortium of Greater Louisville area physicians, hospitals, health plans, employers, labor, and academic medical centers in consultation with the Greater Louisville Medical Society. The reports allow you to benchmark your group s data for private and public comparison to the community average and benchmark. To implement this initiative, Anthem Blue Cross Blue Shield, CoventryCares of Kentucky, Humana Health Plan of Kentucky, and Passport Health Plan provided claims data derived from their 201 HEDIS submissions; Monroe Associates consolidated these data. Enclosed are the following items for your review and action: This Letter with your Encrypted Number for Web-Based Report. Website link WEBKEY KHC Group Practice Public Display Opt Out Form Your Group s Private Consolidated Measurement Report Your Group s Public Consolidated Measurement Report 201 Summary of Consolidated Measurement Report Evaluation Survey We ask that you consider being a leader in the community by promoting healthcare transparency in the region by not opting out. If you do choose to opt out, we ask that you send your opt out form no later than Friday, April 4 th, If you would like to list your group practice in our database along with your contact information, we ask that you complete the opt out form and simply check registration only. Please contact the KHC Executive Directors, Randa Deaton (rdeaton@ford.com) or Teresa Campbell (tcampb10@ford.com) at l for additional information. Physicians are available to answer any question you may have. John N. Lewis, MD, MPH Co-Chair, KHC Steve Barger Co-Chair, KHC Larry Caruso Co-Chair, KHC 190 Bishop Lane, Suite 102 Louisville, KY

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5 GROUP PRACTICE PUBLIC REPORTING OPT OUT AND REGISTRATION FORM The Kentuckiana Health Collaborative is a 01c non profit organization dedicated to improving community health through broad collaboration of key healthcare stakeholders. In the second quarter of 2014, the Kentuckiana Health Collaborative will be publicly reporting group practice consolidated measurement data for the first time. Group practices have the opportunity to opt out during a 4 day review period. PROVIDERS ASSOCIATES PSC 12 MAIN ST STE 100 LOUISVILLE, KY Please complete the below information and submit by Friday, April 4 th. Forms submitted through the postal service that are NOT postmarked by April 4 th, 2014 will be publicly displayed. Groups that opt out will be listed as not participating. OPT OUT: I choose to OPT OUT of my group practice scores being publicly reported in REGISTRATION ONLY: I would like to register in your database for future communication. Group Name: Tax ID #: Name/Title Quality Lead/Practice Manager: Phone: ( ) Extension Address: Quality Lead: Zip: Authorized Signature: Date of Request: Reason for Opt Out: Send completed request form to the Kentuckiana Health Collaborative, Attn: Group Practice OPT Out/Registration, 190 Bishop Lane, Suite 102, Louisville, KY or signed form to rdeaton@ford.com or tcampb10@ford.com.

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7 PROVIDERS ASSOCIATES PSC 12 MAIN ST STE 100 LOUISVILLE, KY PRIVATE GROUP FEEDBACK REPORT For Your Review Only Web Access Code: KEYKEY41

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9 PROVIDERS ASSOCIATES PSC Group Provider Private Feedback Report January 2012 December MAIN ST STE 100 LOUISVILLE, KY This group report is being sent to group practice physician leads for select measures. Anthem, CoventryCares, Humana, and Passport Health provided only administrative data for these reports, which were created using the annual KHC Consolidated Measurement Reports to individual providers. Individual provider data is not being released. Each group practice was given the opportunity to create the list of primary care providers to be included in the report. Calculations include patients for whom members of the group practice provided the most preventive care or outpatient services in COMMERCIAL MEDICAID COMBINED Your 1 Compared to Kentuckiana: Your 1 Compared to Kentuckiana: Your 1 Compared to Kentuckiana: Group 2 Avg. B/W Top 2% B/W Group 2 Avg. B/W 4 Top 2% B/W Group 2 Avg. B/W 4 Top 2% B/W Preventive Care Management Breast Cancer Screening Denominator 176 1, , ,717 Mammogram Performed % 7% 9% % 8% 92% 4% 78% 9% Cervical Cancer Screening Denominator , , ,8 Pap Test Performed 66% 7% 94% 6% 86% 9% 6% 80% 94% Chlamydia Screening Denominator 7 2,94 26,49 6 6,404 Screening Performed 4% 2% 79% 42% 9% 77% 4% % 78% Colorectal Cancer Screening Denominator 22 6, , ,602 Appropriate Screening 60% 1% 76% 7% 49% 7% 9% 0% 76% Childhood Immunization Denominator 10 1, ,488 DTaP 0% 68% 84% 7% 6% 8% % 67% 84% Polio 70% 77% 90% 71% 7% 89% 71% 7% = 90% MMR 70% 94% 98% 86% 89% 98% 76% 92% 98% HiB (H Influenza Type B) 80% 80% = 9% 86% 76% 92% 82% 78% 9% Hepatitis B 0% 10% % 0% 10% 2% 0% 10% % Chicken Pox 70% 9% 98% 86% 90% 98% 76% 9% 98% 6 PCV (Pnemococcal conjugate) % 68% 86% 7% 6% 8% 9% 67% 86% Hepatitis A 0% 4% 74% 14% 1% 7% 6% % 74% Rotavirus 10% 6% 84% 14% 62% 82% 12% 64% 8% Influenza 20% 64% 8% 29% 61% 82% 24% 6% 8% Adolesc. Immunization Denominator 18 1, ,9 All Recommended 78% 74% 90% 8% 71% 88% 80% 7% 89% Well-Child Visits 0-1 m.o. 6 1, ,279 At Least 6 Visits 8% 90% 97% 100% 8% 96% 90% 88% 97%

10 PROVIDERS ASSOCIATES PSC Group Provider Private Feedback Report January 2012 December MAIN ST STE 100 LOUISVILLE, KY COMMERCIAL MEDICAID COMBINED Your 1 Compared to Kentuckiana: Your 1 Compared to Kentuckiana: Your 1 Compared to Kentuckiana: Group 2 Avg. B/W Top 2% B/W Group 2 Avg. B/W 4 Top 2% B/W Group 2 Avg. B/W 4 Top 2% B/W Preventive Care Management Well-Child Visits -6 y.o. 1 6, ,782 At Least 1 Visit 67% 80% 89% 68% 76% 89% 67% 78% 89% Acute Care Management Pediatric Pharyngitis Denominator 12 2, ,091 Group A Strep. Test 8% 87% 96% 67% 82% 96% 62% 8% 96% Pediatric Upper Resp. Infection Denominator 22 2, ,416 No Antibiotic Rx 9% 78% 94% 6% 74% 9% 8% 76% 94% Low Back Pain Denominator 8 2,40 1 2,78 6 Appropriate Use of Imaging Study 6 6 % 69% 88% 80% 66% 87% 62% 68% 88% Adults with Acute Bronchitis Denominator 22 1, ,99 No Antibiotic Rx 2% 1% % 2% 1% % 24% 1% 4% Chronic Disease Care Management Diabetes Denominator 8 10, , ,242 HbA1c Tested 91% 94% 98% 8% 89% 98% 89% 92% 98% 6 HbA1c Control (Tested < 8%) 6 6 0% 79% 9% 67% 7% 92% 7% 77% 9% 6 6 HbA1c Poor Control (Tested > 9%) 6 0% 12% 26% 17% 12% 2% 7% 12% 26% LDL-C Screening Performed 8% 89% 97% 78% 84% 96% 81% 87% 97% LDL-C Control (Tested < 100 mg/dl) 100% 68% 84% 100% 6% 8% 100% 67% 84% LDL-C Control (Tested < 10 mg/dl) 100% 91% 97% 100% 86% 97% 100% 89% 97% Nephropathy Monitored 78% 88% 97% 7% 8% 96% 76% 86% 97% 6 Eye Exam (Retinal) Performed 6 6 8% 4% 62% 8% 4% 61% 8% 44% 62% 6 Diabetes Screening Composite % 79% 77% 70% 7% 77% 71% 77% 77% Asthma Denominator Appropriate Medication 100% 96% 99% 100% 91% 98% 100% 94% 99% Controller Medication Ratio 78% 87% 96% 100% 82% 96% 87% 8% 96% Med. Management (on Controller >0%) 6% 68% 89% 67% 6% 87% 64% 67% 88% Med. Management (on Controller >7%) 8% 44% 72% % 42% 70% 6% 4% 71%

11 PROVIDERS ASSOCIATES PSC Group Provider Private Feedback Report January 2012 December MAIN ST STE 100 LOUISVILLE, KY COMMERCIAL MEDICAID COMBINED Your 1 Compared to Kentuckiana: Your 1 Compared to Kentuckiana: Your 1 Compared to Kentuckiana: Group 2 Avg. B/W Top 2% B/W Group 2 Avg. B/W 4 Top 2% B/W Group 2 Avg. B/W 4 Top 2% B/W Chronic Disease Care Management COPD Denominator 2 1, ,004 Use of Spirometry Testing 48% 46% 79% 44% N/A 77% N/A 48% 4% 78% Antidepressant Medication Denominator Effective Acute Phase Treatment 6 6 8% 7% 9% 6% 70% 92% 60% 72% 9% Effective Continuous Phase Treatment 0% % 82% 0% 2% 80% 0% 4% 81% Hospitalization for Mental Illness Denominator Follow-up within 7 Days after Discharge 29% 47% 66% % 4% 6% 1% 46% 66% Follow-up within 0 Days after Discharge 71% 70% 84% 67% 67% = 8% 69% 69% = 84% 1 Performance of providers in Kentucky s Jefferson, Oldham, and Bullitt counties and Indiana s Floyd, Clark, Harrison, and Scott counties. 2 The total average across the measure's aggregate denominator (i.e., eligible patients or events) for the region. Symbols represent better (" "), worse (" "), or equal ("=") performance compared to the average or benchmark; "N/A" means that data are not available for comparison. 4 The rate met or exceeded by the top 2% of individual providers in Kentuckiana. This measure has changed from previous years to match HEDIS specifications. It includes adults between 1 and 7 years old in the denominator populaiton. 6 These measures only include patients who received the listed test and whose most recent lab values are present in health plan data. This differs from HEDIS specifications.

12 PROVIDERS ASSOCIATES PSC Private Individual Provider Feedback Report January 2012 December 2012 Your Group Average - Commercial Your Group Average - Medicaid Kentuckiana Average Preventive Care Management Kentuckiana 2th Percentile Acute Care Management Preventive Screening Pediatric Care Testing and Antibiotic Use Mammogram Pap Test Chlamydia Screen Colo. Screen Adolesc. Immun. Well-Child 0-1 mo. Group A Strep Test URI - No Rx LBP Bronchitis Chronic Disease Management Diabetes COPD HbA1c Test HbA1c < 8.0% HbA1c > 9.0% LDL-C Test LDL-C < 100 LDL-C < 10 URI - No Rx Nephropathy Composite Asthma Cardiac Care Mental Illness and Depression Controller Rx Controller Ratio Med Tx > 0% Med Tx > 7% Follow-up 7 Days Follow-up 0 Days Antidep. Rx Acute Antidep. 180 days

13 Explanation of Measures Consolidated Measurement Report January 2012 December 2012 All provider and community measures use criteria established by the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans (see for more information). This report used administrative data only. No chart review was conducted. MEASURE ELIGIBLE POPULATION NUMERATOR CRITERIA Preventive Care Management Breast Cancer Screening Females 42 to 69 years of age At least one mammogram in 2011 or 2012 Cervical Cancer Screening Females 24 to 64 years of age At least one Pap test in 2010, 2011, or 2012 Chlamydia Screening Females 16 to 24 years of age identified as sexually At least one chlamydia test during 2012 active Colorectal Cancer Screening Patients 1 to 7 years of age Any of: (1) A fecal occult blood test in 2012, (2) flexible sigmoidoscopy between 2008 and 2012, or () colonoscopy between 200 and 2012 Childhood Immunization Children who turned 2 years old during 2012 All recommended vaccines by second birthday Immunization for Adolescents Children who turned 1 years old during 2012 Before 1th birthday, one dose of meningococcal and one dose of either Tdap vaccine or one Td vaccine Well-Child Visits in First 1 Children who turned 1 months old during 2012 At least 6 well-child visits with a PCP in 2012 Months of Life Well-Child Visits in Years -6 Children to 6 years of age during 2012 At least one well-child visit with PCP during 2012 Acute Care Management Pediatric Pharyngitis Testing Patients 2 to 18 years of age diagnosed with pharyngitis and dispensed an antibiotic A group A streptococcus test administered between days before and days after the episode start date Pediatric Upper Respiratory Patients months to 18 years of age with only a Not dispensed antibiotic Rx on or up to days after the episode start date Tract Infection Treatment Dx of Upper Respiratory Infection during intake Low Back Pain Patients 18 to 0 years of age who had ED or outpatient visit with primary Dx of low back pain Did not receive imaging study (X-Ray, MRI, CT) on or up to 28 days after episode start date Acute Bronchitis in Adults Patients 18 to 64 years of age diagnosed with acute bronchitis Not dispensed antibiotic Rx on or up to days after the episode start date

14 Explanation of Measures Consolidated Measurement Report January 2012 December 2012 MEASURE Chronic Disease Management Comprehensive Adult Diabetes Care HbA1c Control in Patients with Diabetes LDL-C Control in Patients with Diabetes Asthma - Use of Appropriate Medication and Medication Management Spirometry Testing in COPD Assessment and Diagnosis LDL Control in Patients with Ischemic Vascular Disease or Other Cardiac Conditions Persistence of Beta-Blocker Treatment after Heart Attack Follow-up after Hospitalization for Mental Illness Antidepressant Medication Management ELIGIBLE POPULATION Patients 18 to 7 years of age with diabetes (type 1 or type 2) As above, but only includes patients for whom HbA1c lab values from 2012 are available As above, but only includes patients for whom LDL- C lab values from 2012 are available Patients to 64 years of age with persistent asthma Patients at least 42 years of age with newly diagnosed or active (2 years since Dx or Tx) COPD Patients 18 to 7 years of age who either (a) were discharged alive for AMI, CABG, or PCI between 1/01/2011 and 10/1/2011 or (b) had a diagnosis of IVD during both 2011 and 2012 Patients at least 18 years of age discharged alive with AMI from acute inpatient setting between 7/01/2011 and 6/0/2012 Patients at least 6 years of age who were hospitalized for selected mental health disorders in 2012 Patients at least 18 years of age and up by 4/0/12 who were diagnosed with a new episode of depression and treated with medication NUMERATOR CRITERIA HbA1c: An HbA1c test performed in 2012 Eye Exam: An eye screening for diabetic retinal disease; requires a retinal or dilated eye exam by eye care professional in 2012 or negative retinal or dilated eye exam by eye care professional in 2011 Nephropathy: Nephropathy screening test or evidence of nephropathy in 2012 LDL-C: An LDL-C test performed during 2012 HbA1c Control: Most recent HbA1c from test in 2012 is < 8.0% HbA1c Poor Control: Most recent HbA1c from test in 2012 is > 9.0% LDL-C Control: Most recent LDL-C level from test in 2012 is <100 mg/dl LDL-C 10: Most recent LDL-C level from test in 2012 is <10 mg/dl Appropriate Med.: At least one Rx for asthma controller dispensed during 2012 Med. Ratio: Asthma controllers compose > 0% of total asthma medications Med. Management: Member remained on controller medication for at least 0% of treatment period during 2012 Med. Management 7: As above, but for > 7% of the treatment period At least one claim/encounter with spirometry testing between 70 days before and 180 days after the episode start date Complete lipid profile during 2012 and most recent LDL-C level was below 100mg/dL A 180-day course of treatment with beta blockers following discharge 7: Received follow-up with mental health practitioner within 7 days of discharge 0: As above, but within 0 days of discharge Acute Phase: At least 84 days of continuous treatment Continuation Phase: At least 180 days of continuous treatment

15 PROVIDERS ASSOCIATES PSC 12 MAIN ST STE 100 LOUISVILLE, KY SCORES THAT WILL BE PUBLICLY REPORTED ACTION REQUIRED

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17 PROVIDERS ASSOCIATES PSC 12 MAIN ST STE 100 LOUISVILLE, KY Scores to be Publicly Reported Group Provider Feedback Report January 2012 December 2012 This group report is being sent to group practice physician leads for select measures. This version of the report only shows the measures that will be publicly reported unless your group opts out of public reporting. Anthem, Covetry Cares, Humana, and Passport Health provided only administrative data for these reports, which were created using the annual KHC Consolidated Measurement Reports to individual providers. Individual provider data is not being released. Each group practice was given the opportunity to create the list of primary care providers to be included in the report. Calculations include patients for whom members of the group practice provided the most preventive care or outpatient services in Pediatric Upper Resp. Infection Denominator 8 No Antibiotic Rx 8% Low Back Pain Denominator Appropriate Use of Imaging Study 62% Adults with Acute Bronchitis Denominator 8 No Antibiotic Rx 24% Diabetes Denominator 98 HbA1c Tested 89% LDL C Screening Performed 81% Nephropathy Monitored 76% Eye Exam (Retinal) Performed 8% Diabetes Screening Composite 71%

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19 KENTUCKIANA COMMUNITY AVERAGES AND BENCHMARK SCORES

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21 Kentuckiana Average Report January 2012 December 2012 The community measures reflect the overall performance of providers in Kentuckiana. Your performance as an individual is not highlighted in these measures. Measure Average 12 Benchmark Change 4 Measure Average 12 Benchmark Change 4 Preventive Care Management Chronic Disease Management Breast Cancer Screening Denominator,717,4 Diabetes Denominator 14,242 1,47 Mammogram Performed 78% 98% HbA1c Tested 92% 100% Cervical Cancer Screening Denominator 42,82 4,427 HbA1c Control (HbA1c < 8%) 6 77% 98% N/A Pap Test Performed 80% 99% HbA1c Poor Control (HbA1c > 9%) 6 12% N/A N/A Chlamydia Screening Denominator 6, LDL-C Screening Performed 87% 100% Screening Performed % 87% N/A LDL-C Control ( < 100mg/dL) 6 67% 90% N/A Colorectal Cancer Screening Denominator 49,602,021 LDL-C Control ( < 10mg/dL) 6 89% 100% N/A Appropriate Screening 0% 8% N/A Eye Exam (Retinal) Performed 44% 68% = Adolescent Immunization Denominator 1,9 14 Nephropathy Monitored 86% 100% All Recommended 7% 8% N/A Asthma Denominator 6 6 Well-Child Visits 0-1 m.o. 1, Appropriate Medication 94% 100% At Least 6 Visits 86% 100% N/A Controller Medication Ratio 8% 100% N/A Well-Child Visits Age - 6 y.o. 7, Med. Management (on Controller >0%) 67% 96% N/A At Least 1 Visit 78% 9% N/A Med. Management (on Controller >7%) 4% 82% N/A Acute Care Management COPD Denominator 2, Pediatric Pharyngitis Denominator, Use of Spirometry Testing 4% 90% N/A Group A Strep. Test 8% 100% CMC/IVD: LDL Control Denominator Pediatric Upper Resp. Infection Denominator 2, LDL-C < 100 in Cardiac Patients 6 77% 100% N/A No Antibiotic Rx 76% 100% Hospitalization for Mental Illness Denominator 14 1 Low Back Pain Denominator 2, Follow-up within 7 Days after Discharge 46% 7% Appropriate Use of Imaging Study 68% 9% = Follow-up within 0 Days after Discharge 69% 89% Adults with Acute Bronchitis Denominator 1, Antidepressant Medication Denominator No Antibiotic Rx 1% 41% Effective Acute Phase Treatment 72% 100% Effective Continuous Phase Treatment 4% 91% 1 Performance of providers in Kentucky s Jefferson, Oldham, and Bullitt counties and Indiana s Floyd, Clark, Harrison, and Scott counties. 2 The total average across the measure's aggregate denominator (i.e., eligible patients or events) for the region. The average rate for the top-ranked providers, whose combined patients account for 10% of the total population in this report. 4 Symbols represent better (" "), worse (" "), or equal ("=") performance compared to last year; "N/A" means that data are not available for comparison. This measure has changed from previous years to match HEDIS specifications. It includes adults between 1 and 7 years old in the denominator populaiton. 6 These measures only include patients who received the appropriate test and whose most recent lab values are present in health plan data. This differs from HEDIS specifications.

22 Kentuckiana Average Report January 2012 December 2012 The community measures reflect the overall performance of providers in Kentuckiana. Your performance as an individual is not highlighted in these measures. Measure Average 12 Benchmark Preventive Care Management Childhood Immunizations 1, DTaP 67% 90% Polio 6% 9% MMR 92% 100% HiB (H Influenza Type B) 78% 98% Hepatitis B 10% 41% Chicken Pox 9% 100% PCV (Pnemococcal conjugate) 67% 92% Hepatitis A % 91% Rotavirus 64% 90% Influenza 6% 90% Performance of providers in Kentucky s Jefferson, Oldham, and Bullitt counties and Indiana s Floyd, Clark, Harrison, and Scott counties. The total average across the measure's aggregate denominator (i.e., eligible patients or events) for the region. The average rate for the top-ranked providers, whose combined patients account for 10% of the total population in this report.

23 Explanation of Measures Consolidated Measurement Report January 2012 December 2012 All provider and community measures use criteria established by the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans (see for more information). This report used administrative data only. No chart review was conducted. MEASURE ELIGIBLE POPULATION NUMERATOR CRITERIA Preventive Care Management Breast Cancer Screening Females 42 to 69 years of age At least one mammogram in 2011 or 2012 Cervical Cancer Screening Females 24 to 64 years of age At least one Pap test in 2010, 2011, or 2012 Chlamydia Screening Females 16 to 24 years of age identified as sexually At least one chlamydia test during 2012 active Colorectal Cancer Screening Patients 1 to 7 years of age Any of: (1) A fecal occult blood test in 2012, (2) flexible sigmoidoscopy between 2008 and 2012, or () colonoscopy between 200 and 2012 Childhood Immunization Children who turned 2 years old during 2012 All recommended vaccines by second birthday Immunization for Adolescents Children who turned 1 years old during 2012 Before 1th birthday, one dose of meningococcal and one dose of either Tdap vaccine or one Td vaccine Well-Child Visits in First 1 Children who turned 1 months old during 2012 At least 6 well-child visits with a PCP in 2012 Months of Life Well-Child Visits in Years -6 Children to 6 years of age during 2012 At least one well-child visit with PCP during 2012 Acute Care Management Pediatric Pharyngitis Testing Patients 2 to 18 years of age diagnosed with pharyngitis and dispensed an antibiotic A group A streptococcus test administered between days before and days after the episode start date Pediatric Upper Respiratory Patients months to 18 years of age with only a Not dispensed antibiotic Rx on or up to days after the episode start date Tract Infection Treatment Dx of Upper Respiratory Infection during intake Low Back Pain Patients 18 to 0 years of age who had ED or outpatient visit with primary Dx of low back pain Did not receive imaging study (X-Ray, MRI, CT) on or up to 28 days after episode start date Acute Bronchitis in Adults Patients 18 to 64 years of age diagnosed with acute bronchitis Not dispensed antibiotic Rx on or up to days after the episode start date

24 Explanation of Measures Consolidated Measurement Report January 2012 December 2012 MEASURE Chronic Disease Management Comprehensive Adult Diabetes Care HbA1c Control in Patients with Diabetes LDL-C Control in Patients with Diabetes Asthma - Use of Appropriate Medication and Medication Management Spirometry Testing in COPD Assessment and Diagnosis LDL Control in Patients with Ischemic Vascular Disease or Other Cardiac Conditions Persistence of Beta-Blocker Treatment after Heart Attack Follow-up after Hospitalization for Mental Illness Antidepressant Medication Management ELIGIBLE POPULATION Patients 18 to 7 years of age with diabetes (type 1 or type 2) As above, but only includes patients for whom HbA1c lab values from 2012 are available As above, but only includes patients for whom LDL- C lab values from 2012 are available Patients to 64 years of age with persistent asthma Patients at least 42 years of age with newly diagnosed or active (2 years since Dx or Tx) COPD Patients 18 to 7 years of age who either (a) were discharged alive for AMI, CABG, or PCI between 1/01/2011 and 10/1/2011 or (b) had a diagnosis of IVD during both 2011 and 2012 Patients at least 18 years of age discharged alive with AMI from acute inpatient setting between 7/01/2011 and 6/0/2012 Patients at least 6 years of age who were hospitalized for selected mental health disorders in 2012 Patients at least 18 years of age and up by 4/0/12 who were diagnosed with a new episode of depression and treated with medication NUMERATOR CRITERIA HbA1c: An HbA1c test performed in 2012 Eye Exam: An eye screening for diabetic retinal disease; requires a retinal or dilated eye exam by eye care professional in 2012 or negative retinal or dilated eye exam by eye care professional in 2011 Nephropathy: Nephropathy screening test or evidence of nephropathy in 2012 LDL-C: An LDL-C test performed during 2012 HbA1c Control: Most recent HbA1c from test in 2012 is < 8.0% HbA1c Poor Control: Most recent HbA1c from test in 2012 is > 9.0% LDL-C Control: Most recent LDL-C level from test in 2012 is <100 mg/dl LDL-C 10: Most recent LDL-C level from test in 2012 is <10 mg/dl Appropriate Med.: At least one Rx for asthma controller dispensed during 2012 Med. Ratio: Asthma controllers compose > 0% of total asthma medications Med. Management: Member remained on controller medication for at least 0% of treatment period during 2012 Med. Management 7: As above, but for > 7% of the treatment period At least one claim/encounter with spirometry testing between 70 days before and 180 days after the episode start date Complete lipid profile during 2012 and most recent LDL-C level was below 100mg/dL A 180-day course of treatment with beta blockers following discharge 7: Received follow-up with mental health practitioner within 7 days of discharge 0: As above, but within 0 days of discharge Acute Phase: At least 84 days of continuous treatment Continuation Phase: At least 180 days of continuous treatment

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